Atropine and pralidoxime are the proper antidotes for pts w what poisoning

organophosphate

Important RQ ratios

RQ 1.0= predominant oxidation of carbs and net lipogenesis

RQ 0.8= protein predominant

RQ 0.7= lipid predominant

Etiology of incidence of brain tumors

Lung>breast>unk primary>melanoma>colon

Smudge cells =

Chronic lymphocytic leukemia

Chronic ax's of CF

-recurrent sinopulmonary infections

-chronic cough

-nasal polyps

-digital clubbing

Drugs of choice in Ventricular Fibrillation

Epinephrine or vasopressin

2nd line: amiodarone

Hereditary Hemochromatosis

Initial sxs: fatigue & impotence, hepatomegaly

-screen with TIBC & ferritin level

-Dx: genetic testing and liver bx

-tx: phlebotomy

Bronchiolitis

Caused by: Respiratory syncytial virus

Tx: humidified O2, Ribavirin

Croup

Caused by: Parainfluenza virus

-steeple sign

-tx: dexamethasone, nebulized epinephrine

Epiglottitis

Caused by: nontypable H.flu

-swollen epiglottis on lateral x-ray (steeple sign)

-establish airway, abx (3rd gen cephalosporin, MRSA coverage)

Treatment of opioid overdose

Naloxone

Always perform ___in the setting of third trimester bleed before doing pelvic exam

US

What type of neonatal infection is not prevented by intrapartum eye drops

Chlamydia

Carotid stenosis of 70-99% is treated with

CEA

Carotid Ar stenosis of less than 50% is treated with

Medical mgmt.

Overdoses and mgmt

Acetaminophen: Acetylcysteine

Benxos: Flumazenil (only if certain there is no dependence)

BB: Glucagon

Carbon Monoxide: Oxygen

Cholinesterase inhibitors: atropine, pralidoximine

Copper, gold: penicilliamine

Digoxin: Normalize K, digoxin ab

Poison or Med and Antidote

Iron: Deferoxamine

Lead:EDTA

Methanol or ethylene glycol: Fomepizole, ethanol

Muscarinic blockers: physostigmine

Opioids: Naloxone

Quinidine or TCAs: Sodium Bicarb

tardive dyskinesia

involves the appearance of slow, involuntary and uncontrollable rhythmic movements and rapid twitching of the mouth and lips, as well as unusual movements of the limbs; this condition is associated with the continued use of typical neuroleptics

Akathesia

Subjective sense of restlessness in the whole body or part

Injuries to distal third of clavicle may need

open reduction and internal fixation to prevent nonunion

Important causes of thyrotoxicosis with low radioactive iodine uptake

1.subacute painless thyroiditis

2. subacute granulomatous thyroiditis

3. iodine induced thyroid toxicosis

4. levothyroxine overdose

5. struma ovarii

Quad screen findings in down syndrome

B-hCG and Inhibin A: elevated

MSAFP & Estriol: decreased

Amniotic fluid embolism syndrome

-rapid onset hypotension

-DIC

-shock

-seizures

tx: respiratory support and +/- transfusion

If neonate presents with esophageal defects what should you look for next?

V:Vertebral

A:anal atresia

C:Cardiac

T:transesophageal fistula

R: Renal

L: limb defects

Breastfeeding failure jaundice

Unconjugated hyperbilirubinemia

-inadequate stooling

-dehydrated

-red urate crystals in diaper

Breast milk jaundice

No signs of dehydration or feeding problems

dubin-johnson

increased CONJUGATED bili -- defective liver excretion

grossly black liver

benign

rotor's - similar but does not cause black liver

Neonatal exchange transfusion

Reserved for bilirubin>25 or those with bilirubin-induced neurologic consequences

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